Key result
Mean maximal fitness declined from 613 seconds at age 20 to 357 seconds at age 50, with women and specific sociodemographic groups showing persistently lower fitness over time (P<0.001).
Why the study?
The study aimed to describe maximal and submaximal cardiorespiratory fitness from early adulthood to midlife and evaluate differences in fitness and changes over time by sociodemographic, behavioral, and health-related factors.
Cohort (n=5,018)
Cardiorespiratory fitness declines significantly from early adulthood to midlife, with disparities based on sex, race, and socioeconomic factors persisting throughout this period.
Fitness declines start early in adulthood and vary by lifestyle factors; leaves open optimal intervention timing before midlife.
PURPOSE: This study aimed to describe maximal and submaximal cardiorespiratory fitness from early adulthood to midlife and examine differences in maximal fitness at age 20 yr and changes in fitness overtime by subcategories of sociodemographic, behavioral, and health-related factors. METHODS: Data include 5018 Coronary Artery Risk Development in Young Adults participants (mean (SD) age, 24.8 (3.7) yr; 53.3% female; and 51.4% Black participants) who completed at least one maximal graded exercise test at baseline and/or the year 7 and 20 exams. Maximal and submaximal fitness were estimated by exercise duration and heart rate at the end of stage 2. Multivariable adjusted linear-mixed models were used to estimate fitness trajectories using age as the mechanism for time after adjustment for covariates. Fitness trajectories from ages 20 to 50 yr in 5-yr increments were estimated overall and by subgroups determined by each factor after adjustment for duration within the less favorable category. RESULTS: Mean (95% confidence interval) maximal fitness at age 20 and 50 yr was 613 (607-616) and 357 (350-362) s; submaximal heart rate during this period also reflected age-related fitness declines (126 (125-127) and 138 (137-138) bpm). Compared with men, women had lower maximal fitness at age 20 yr (P < 0.001), which persisted over follow-up (P < 0.001); differences were also found by race within sex strata (all P < 0.001). Differences in maximal fitness at age 20 yr were noted by socioeconomic, behavioral, and health-related status in young adulthood (all P < 0.05), which persisted over follow-up (all P < 0.001) and were generally consistent in sex-stratified analyses. CONCLUSIONS: Targeting individuals experiencing accelerated fitness declines with tailored intervention strategies may provide an opportunity to preserve fitness throughout midlife to reduce lifetime cardiovascular disease risk.
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Gabriel et al. (2022) conducted a cohort in Age-related declines in cardiorespiratory fitness (n=5,018). Sociodemographic, behavioral, and health-related factors was evaluated on Maximal and submaximal cardiorespiratory fitness trajectories from age 20 to 50 years. Mean maximal fitness declined from 613 seconds at age 20 to 357 seconds at age 50, with women and specific sociodemographic groups showing persistently lower fitness over time (P<0.001).
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